More than half of Minnesotans report childhood experiences linked to long-term health outcomes

More than half of Minnesotans have had an adverse experience in their childhood that could have a life-long impact on their health and well-being, according to data released Monday by the Minnesota Department of Health.

The Minnesota Department of Health surveyed 13,520 Minnesota adults in 2011 and found that 55 percent of them reported having at least one adverse childhood experience (ACE) such as divorce or separation of their parents; an incarcerated household member; a mentally ill parent; domestic violence against a parent; a household member with an alcohol or substance abuse problem, or verbal, physical, or sexual abuse.

"The significance of this study is that it shows that these experiences, which can significantly affect the health and well-being of adults decades later, are much more common in Minnesota than one might expect," said Dr. Ed Ehlinger, Minnesota Commissioner of Health. "Our task now is to learn from this information and use these insights to better identify and support children and families at risk."

The four most common adverse experiences reported by adults include verbal abuse at 28 percent, a drinking problem in the household at 24 percent, mental illness in the household 17 percent, and physical abuse at 16 percent.

With the collection of these data, Minnesota is one of 18 states that have surveyed residents in an effort to better understand the impact of adverse childhood experiences on the health and well-being of adults. Minnesota collected ACE data for the first time in 2011, as part of the Behavioral Risk Factor Surveillance System (BRFSS), which is a national telephone survey conducted by states.

Minnesota's report contributes to a growing body of research that shows a strong link between adverse childhood experiences (ACEs), toxic stress, changes in brain chemistry, and life-long outcomes. For two decades, research by the Centers for Disease Control and Prevention (CDC) and other states has demonstrated over and over again the powerful impact of ACEs on health, behavioral, and social problems. An extensive and growing body of research documents that adverse childhood experiences (ACEs)—those causing toxic levels of stress or trauma before age 18—are specifically linked to poor physical and mental health, chronic disease, lower educational achievement, and lower economic success in adulthood.

Minnesota's results are consistent with those found by the initial ACE study and in other states. First, ACEs are common; second, ACEs frequently occur together, and third, higher ACE scores put a person more at risk for poorer health and well-being outcomes as an adult. For example, Minnesotans with more ACEs were more likely to rate their health as fair or poor, to have been diagnosed with depression or anxiety, to report smoking and chronic drinking, to have been diagnosed with asthma, and to be obese. In addition, ACEs are more common among Minnesotans who did not graduate from high school, who were unmarried, who rented rather than owned their own home, who were unemployed, or who worried about paying their mortgage or rent or about buying nutritious food. Second, ACEs frequently occur together. In Minnesota, over half of Minnesotans experiencing ACEs had more than two ACEs; and third, ACEs have a strong and cumulative impact on the health and functioning of adults.

For example, the study found the following associations between ACEs and outcomes.

19 percent of adults with five or more ACEs rated their health as "fair or poor" compared to 9 percent of adults with no ACEs.

Minnesotans reporting five or more ACEs were more than twice as likely to have had asthma, than adults reporting no ACEs.

Minnesota adults who were frequently worried or stressed about having enough money for shelter and nutritious meals were more than 2.5 times more likely to have experienced five or more ACEs than adults who had these feelings less often.

Although the volume of abuse and dysfunction is significant, such traumatic experiences cannot be used to describe a person or determine who that person will be. Instead, keeping track of these adverse experiences is important to gain a better understanding of them and their effect on society.

"Though this research shows that adversity increases risk, it is also clear that adversity is not destiny and many people with high ACE scores overcome challenging childhoods," said MDH Assistant Commissioner Jeanne Ayers. "Part of the value of this research is that we can let people know they are not alone in these experiences, and that they can break the cycle and prevent ACEs instead of dealing with their impact later."

As part of Governor Mark Dayton's Children's Cabinet, the Minnesota Department of Health plans to work with other state agencies to find ways to reduce ACEs and improve the lives of adults. Other communities and states, such as Washington, have rallied around the idea of combating the negative effects of ACEs with the concept of resiliency. For example, positive experiences at school or a loving adult involved in a child's life can help a child overcome exposure to ACEs.

"The hopeful part of ACEs research is that it is stimulating communities to take action to protect children early in their lives and find new ways to help children, families, and communities to become more resilient," Ehlinger said. "We will use this information to launch similar efforts here in Minnesota."
The complete report is expected to be available in February.